Candida vulvovaginitis medical therapy
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Candida vulvovaginitis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Antifungal agents are indicated in candidiasis. Commonly used drugs include Amphotericin, Clotrimazole, Nystatin, Fluconazole and Ketoconazole. It is important to consider that Candida species are frequently part of the human body's normal oral and intestinal flora. Candidiasis is occasionally misdiagnosed by medical personnel as bacterial in nature, and treated with antibiotics against bacteria. This can lead to eliminating the yeast's natural competitors for resources, and increase the severity of the condition.
Medical Therapy
According to, 2016 Update by the Infectious Diseases Society of America medical therapy for Candida vulvovaginitis includes[1]:
- Uncomplicated Candida Vulvovaginits:
- 1st line :Any topical antifungal agents can be used and all of them have equal efficacy
- Alternative : Single 150mg dose of oral fluconazole is recommended
- Severe acute Candida vulvovaginitis:
- 1st line: Oral fluconazole 150mg, given every 72 hours for a total of 2 or 3 doses
- Candida glabrata: When unresponsive to oral azoles
- 1st line: Topical intravaginal boric acid administered in a gelatin capsule, 600mg daily for 14 days
- 2nd line: Nystatin intravaginal suppositories, 100,000 units daily for 14 days
- 3rd line: Topical 17% flucytosine cream alone or in combination with amphotericin B cream daily for 14 days
- Recurring vulvovaginal candidiasis:
- 1st line: 10 to 14 days of induction therapy with a topical agent or oral fluconazole, followed by fluconazole, 150mg weekly for 6 months
Candida Vulvovaginitis in HIV positive women
- Treatment of symptomatic Candida vulvovaginitis in HIV-positive women is similar to HIV-negative individuals.
References
- ↑ Pappas, Peter G.; Kauffman, Carol A.; Andes, David R.; Clancy, Cornelius J.; Marr, Kieren A.; Ostrosky-Zeichner, Luis; Reboli, Annette C.; Schuster, Mindy G.; Vazquez, Jose A.; Walsh, Thomas J.; Zaoutis, Theoklis E.; Sobel, Jack D. (2015). "Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America". Clinical Infectious Diseases: civ933. doi:10.1093/cid/civ933. ISSN 1058-4838.